Organization
MINNESOTA TEEN CHALLNGE, INC.
Active
Organization
MINNESOTA TEEN CHALLNGE, INC.
Active
Other names
Minnesota Adult and Teen Challenge- Life renewal
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES VINCENT LANGE LADC (TREATMENT DIRECTOR)
(218) 833-8758
Entity
Organization
Contact information
Practice address
313 LAUREL ST, BRAINERD, MN 56401-3522
(218) 833-8758
(218) 828-6932
Mailing address
1619 PORTLAND AVE, MINNEAPOLIS, MN 55404-1507
(218) 833-8777
(218) 828-6932
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1078601-1-CDT
MN
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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